<div class="pageContent">

	<form method="post" action="__URL__/insertPay/navTabId/__MODULE__/callbackType/closeCurrent" class="pageForm required-validate" onsubmit="return validateCallback(this, dialogAjaxDone)">
	   
		<input type="hidden" name="providerid" value="{$providerid}"> 
		<div class="pageFormContent" layoutH="58">
			<div class="unit">
				<label style="margin-right: -10px;">付款方：</label>
				<select name="payer" class="required combox">
						<option value="">请选择</option>
						<volist id="sub" name="subcompany"> 
						<option value="{$sub.subname}">{$sub.subname}</option>
						</volist>
					</select>
			</div>
			<div class="unit">
				<label>收款方：</label>
				<input type="text" name="collection" class="required" alt="请输入收款方" style="width: 360px;" value="{$collection}" readonly>
			</div>
		<!-- 	<div class="unit">
				<label>付款人：</label>
				<input type="text" name="agent">
			</div> -->
			<div class="unit">
				<label>付款时间：</label>
				<input type="text" name="paytime" class="date"/><a class="inputDateButton" href="javascript:;">选择</a>
			</div>
			<div class="unit">
				<label>预估单价：</label>
				<input type="text" name="price">
			</div>
			<div class="unit">
				<label>付款总额：</label>
				<input type="text" name="total">
			</div>
			<!-- <div class="unit">
				<label>已付款：</label>
				<input type="text" name="apayment">
			</div>
			<div class="unit">
				<label>未付款：</label>
				<input type="text" name="wpayment">
			</div> -->
			<div class="unit">
				<label>备注：</label>
				<textarea cols="56" rows="3" name="note" style="width: 360px;"></textarea>
			</div>
		</div>
		
		<div class="formBar">
			<ul>
				<li><div class="buttonActive"><div class="buttonContent"><button type="submit">保存</button></div></div></li>
				<li><div class="button"><div class="buttonContent"><button type="button" class="close">取消</button></div></div></li>
			</ul>
		</div>
	</form>

</div>

